Abstract
Purpose: To investigate the relationship between vectorcardiography (VCG) and myocardial scar on cardiac magnetic resonance (CMR) imaging, and whether combining these metrics may improve cardiac resynchronization therapy (CRT) response prediction. Methods: Thirty-three CRT patients were included. QRS(area), T-area and QRST(area) were derived from the ECG-synthesized VCG. CMR parameters reflecting focal scar core (Scar(2sD), Gray(2sD)) and diffuse fibrosis (pre-T1, extra cellular volume IECVD were assessed. CRT response was defined as >= 15% reduction in left ventricular end-systolic volume after six months' follow-up. Results: VCG QRS(area), T-area and QRST(area) inversely correlated with focal scar (R = 0.44-0.58 for Scar(2sD), p <= 0.010), but not with diffuse fibrosis. Scar(2SD), GraY(2SD) and QRS(area) predicted CRT response with ADCs of 0.692 (p = 0.063), 0.759 (p = 0.012) and 0.737 (p = 0.022) respectively. A combined ROC-derived threshold for Scar(2sD) and QRS(area) resulted in 92% CRT response rate for patients with large QRSarea and small Scar(2sD) or Gray(2sD). Conclusion: QRS(area) is inversely associated with focal scar on CMR. Incremental predictive value for CRT response is achieved by a combined CMR-QRS(area) analysis. (C) 2018 Elsevier Inc. All rights reserved.
Original language | English |
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Pages (from-to) | 457-463 |
Number of pages | 7 |
Journal | Journal of Electrocardiology |
Volume | 51 |
Issue number | 3 |
DOIs | |
Publication status | Published - 1 May 2018 |
Keywords
- Vectorcardiography
- Myocardial scar
- Cardiac magnetic resonance imaging
- Cardiac resynchronization therapy
- BUNDLE-BRANCH BLOCK
- T-WAVE AREA
- MAGNETIC-RESONANCE
- PREDICTS RESPONSE
- CARDIOMYOPATHY
- ACTIVATION
- MORTALITY